Wichita County gonorrhea cases rise

Official fears bacteria grows more resistant

The medical community in the U.S. has been relegated to treating gonorrhea effectively with one antibiotic, and that has a Wichita Falls-Wichita County Public Health District official concerned, as she has seen the number of cases in the county rise.

Joanna Van Sant, charge nurse of the district's Sexually Transmitted Disease Clinic, said there were 44 cases of gonorrhea in Wichita County in 2011.

Through the first seven months of 2012, she said 39 cases have been reported. She said there are no indicators pointing to why there has been the spike, and there really isn't a strong socioeconomic tie to the increase.

"It's definitely a big increase," she said. "A lot of times people don't have symptoms, so they don't know they have it. The only way they'll know is if they come in and get tested."

Women rarely have symptoms of the bacteria, Van Sant said. But, in the uncommon instance that they do, she said the symptoms are mild and include painful or burning sensation when urinating, increased vaginal discharge and vaginal bleeding between periods.

Women also are at risk of developing severe complications such as pelvic inflammatory disease, chronic pelvic pain and an increase risk of ectopic pregnancy.

Signs and symptoms for males appear about 50 percent of the time, Van Sant said, and include penile discharge, burning or painful urination and swollen testicles.

According to the Centers for Disease Control and Prevention, studies have shown that gonorrhea is resistant to most antibiotics, leaving cefixime and ceftriaxone, an injectable antibiotic, as the remaining medications in the treatment of the bacteria. Cefixime, the CDC said, "is becoming less effective in treating the sexually transmitted disease."

The organization also released new recommendations on treating gonorrhea by limiting the use of cefixime to keep ceftriaxone as a viable treatment option before that, too, no longer is effective.

It is recommended that health care providers treat those diagnosed with the STD with ceftriaxone and one of two oral medications, azithromycin or doxycycline.

Van Sant said the health district has used this method before the CDC's new suggestion was published.

"The treatment regimen the CDC now recommends we've been doing for a while now," she said. "At least for the past year (that I've been here) we've been doing that and I'm sure it's been longer than that."

Even with the recent news by the CDC and the rising numbers of gonorrhea, Van Sant said that's not the scariest part of the issue. She said there is what some are calling a "gonorrhea superbug" in Europe that is already resistant to any treatments, meaning "once you've got it, you're stuck."

Because of the growing case number in the county and the superbug in Europe, Van Sant said she expresses the urgency of the situation to those who go to the clinic to encourage people to get tested and begin treatment before there is no treatment left. And it's not just the individual who should be tested.

"If somebody has it, we always tell them to have any partners they've had in the last 90 days to come in and get tested," she said.

The goal of the CDC's Division of STD Prevention is to get ahead of the superbug and work to find new ways of treating the disease.

"It is imperative that researchers and pharmaceutical companies prioritize research to identify or develop new, effective drugs or drug combinations," Dr. Gail Bolan said. "Health departments and labs can help CDC monitor for emerging resistance by enhancing or rebuilding their ability to do culture testing."

Recommendations by the CDC to prevent contracting gonorrhea include abstaining from sex, condom use, regular screenings and prompt and effective treatment.

The health districts STD Clinic accepts walk-in patients on a first-come, first-served, basis. The cost for services is income-based and ranges from $10-$30.

The clinic is open Monday and Tuesday from 1-3:30 p.m. and Thursday and Friday from 8-10:30 a.m.